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Öğe Analysis of data from three centers in Turkey on intraoperative radiotherapy of breast cancer(Elsevier Science Ltd., 2016) Yıldırım Altınok, Ayşe; Alan, O. Day; Dizdar, Nihal; Çağlar, Hale Başak; İnce, Ümit; Uras, Cihan; Bese, Nuran[Abstract Not Available]Öğe Clinical factors affecting the efficacy of evening primrose oil on mastalgia(Springer, 2020) Balcı, Fatih Levent; Uras, Cihan[Abstract Not Available]Öğe Innovative use of optical coherence tomography catheter via nipple orifice: A case report of first intraductal images of florid ductal hyperplasia(AME Publishing Company, 2019) Balcı, Fatih Levent; Uras, Cihan; Feldman, Sheldon MarcThe incidence of malignancy in patients with pathologic nipple discharge (PND) varies from 1% to 23% (1). Currently, methylene blue dye or lacrimal probe guided isolated duct excision is still the standard treatment of PND. Majority of those patients are not with cancerinvolved ducts and have unnecessary surgery to reveal the definitive histopathology. With conventional imaging, it is not possible to understand whether those ducts involve cancer or not (2). It is well established that ductoscopy is a novel technique that could diagnose a single papilloma; however, it is insufficient to diagnose an in situ or invasive cancer (3,4). Currently, optical coherence tomography (OCT) is used as a non-invasive imaging test that utilizes light waves to capture cross-sectional pictures of retina or coronary arteries (5). In our novel approach, a miniaturized OCT catheter is inserted into the breast ductal system via the nipple orifices to provide detailed real-time imaging of breast ductal epithelial anatomy.Öğe Laser-assisted-indocyanine-green-angiography versus conventional assessment to predct or locate necrotic areas on mastectomy flaps: A prospective clincial trial(Istanbul University, 2019) Balcı, Fatih Levent; Uras, CihanObjective: The aim of this study was to determine whether laser-assisted-indocyanine-green-angiography (LA-ICGA) could accurately predict flap necrosis in comparison to conventional clinical assessment and visually identify its location during immediate reconstruction following a nipple-sparing mastectomy (NSM). Methods: Twenty-one patients with breast cancer were prospectively enrolled to undergo NSM with immediate implant reconstruction. In 19 cases LA-ICGA numbers were used to show the level of laser absorption of hypo-perfused areas on the mastectomy flaps. Those numbers were compared to conventional assessment to assess the predictive value of LA-ICGA. Results: Of the 19 mastectomy flaps, 3 (15.8%) examples of partial skin flap necrosis with an LA-ICGA value of <= 7 was observed. The sensitivity, specificity, false-positive rate, and accuracy of LA-ICGA were 43%, 100%, 57%, and 79%, respectively. Patients with an LA-ICGA value of <= 7 were found more likely to develop mastectomy flap necrosis, whereas patients aged >60 or, a history of smoking, a BMI >30, or intraoperative use of tumescence solution containing epinephrine were more likely to have an LA-ICGA score <= 7 which is not clinically reliable in predicting necrosis.Öğe Locoregional treatment improves survival in de novo bone-only metastatic breast cancer: Long-term results of the prospective, multi-institutional study - protocol BOMET MF14-01(Springer, 2023) Soran, Atilla; Doğan, Lütfi; Işık, Arda; Özbaş, Serdar; Can Trabulus, Didem; Demirci, Umut; Karanlık, Hasan; Soyder, Aykut; Dağ, Ahmet; Bilici, Ahmet; Doğan, Mutlu; Şendur, Mehmet Ali Nahit; Köksal, Hande; Gülçelik, Mehmet Ali; Cabıoğlu, Neslihan; Yeniay, Levent; Utkan, Zafer; Karadurmuş, Nuri; Dağlar, Gül; Şimşek, Turgay; Yıldız, Birol; Uras, Cihan; Tükenmez, Mustafa; Özaslan, Cihangir; Maralcan, Göktürk; Kutun, Suat; Karaman, Niyazi; Toktaş, Osman; Yıldırım, Ahmet Özgen; Akçay, Müfide Nuran; Özmen, Vahit; Sezgin, Efe[Abstract Not Available]Öğe Long-term oncologic safety of nipple-sparing mastectomy in patients with short tumor-nipple distance(Springer, 2020) Balcı, Fatih Levent; Uras, Cihan[Abstract Not Available]Öğe Oncologic safety of nipple-sparing mastectomy in patients with short tumor-nipple distance(Blackwell Publishing Inc., 2019) Balcı, Fatih Levent; Kara, Halil; Dülgeroğlu, Onur; Uras, CihanBackground: There is a tendency to avoid nipple-sparing mastectomy (NSM) when a tumor-nipple distance (TND) is <2 cm due to the risk of occult nipple involvement. The purpose of the study was to determine whether the patients who undergo NSM with immediate reconstruction are oncologically safe when TND is <2 cm. Methods: Patients who underwent NSM followed by immediate reconstruction for breast cancer were retrospectively analyzed. Patients who are negative for nipple-base in either frozen-section or paraffin histopathology were included. MRI was used to obtain TNDs to compare local-recurrence-free and disease-free survival in group I (TND <2 cm) and group II (TND ?2 cm). Disease-free survival rates were determined to assess the outcome. Results: Of the 214 cases with malignancy on MRI, 21 cases diagnosed with pure ductal carcinoma in situ were excluded. Among the 193 NSM cases diagnosed with invasive cancer, TND was <2.0 cm in 59 (30.56%) cases and ?2.0 cm in 134 (69.43%) cases. No significant differences were found between groups in regards to ER, PR, HER2-neu status, and nodal involvement (P = 0.34, P = 0.41, P = 0.54, and P = 0.12 respectively). In a median follow-up time of 62 months (range; 13-114), patients in group I had four local recurrences, whereas group II was found to have five local and three distant metastases. No significant differences were observed between groups concerning disease-free survival (10-year DFS 93.2% vs 96.3%; P = 0.368 respectively). Conclusions: Patients who have invasive cancer diagnosis with a TND <2 cm are eligible to undergo therapeutic NSM with immediate reconstruction.Öğe The effect of primary surgery in patients with de novo stage IV breast cancer with bone metastasis only (Protocol BOMET MF 14-01): A multi-center, prospective registry study(Springer, 2021) Soran, Atilla; Doğan, Lütfi; Işık, Arda; Özbaş, Serdar; Can Trabulus, Didem; Demirci, Umut; Karanlık, Hasan; Soyder, Aykut; Dağ, Ahmet; Bilici, Ahmet; Doğan, Mutlu; Köksal, Hande; Şendur, Mehmet Ali Nahit; Gülçelik, Mehmet Ali; Maralcan, Göktürk; Cabıoğlu, Neslihan; Yeniay, Levent; Utkan, Zafer; Şimşek, Turgay; Karadurmuş, Nuri; Dağlar, Gül; Yıldız, Birol; Uras, Cihan; Tükenmez, Mustafa; Yıldırım, Ahmet; Kutun, Suat; Özaslan, Cihangir; Karaman, Niyazi; Akçay, Müfide Nuran; Toktaş, Osman; Sezgin, EfeBackground More evidence shows that primary surgery for de novo metastatic breast cancer (BC) prolongs overall survival (OS) in selected cases. The aim of this study was to evaluate the role of locoregional treatment (LRT) in BC patients with de novo stage IV bone only metastasis (BOM). Methods The prospective, multicenter registry study BOMET MF14-01 was initiated in May 2014. Patients with de novo stage IV BOM BC were divided into two groups: those receiving systemic treatment (ST group) and those receiving LRT (LRT group). Patients who received LRT were further divided into two groups: ST after LRT (LRT + ST group) and ST before LRT (ST + LRT group). Results We included 505 patients in this study; 240 (47.5%) patients in the ST group and 265 (52.5%) in the LRT group. One hundred and thirteen patients (26.3%) died in the 34-month median follow-up, 85 (35.4%) in the ST group and 28 (10.5%) in LRT group. Local progression was observed in 39 (16.2%) of the patients in the ST group and 18 (6.7%) in the LRT group (p = 0.001). Hazard of death was 60% lower in the LRT group compared with the ST group (HR 0.40, 95% CI 0.30-0.54, p < 0.0001). Conclusion In this prospectively maintained registry study, we found that LRT prolonged survival and decreased locoregional recurrence in the median 3-year follow-up. Timing of primary breast surgery either at diagnosis or after ST provided a survival benefit similar to ST alone in de novo stage IV BOM BC patients.Öğe The effect of primary surgery in patients with stage IV breast cancer with bone metastasis only (protocol bomet MF14-01); a multi-center, registry study(Churchill Livingstone, 2021) Soran, Atilla; Doğan, Lütfi; Özbaş, Serdar; Işık, A.; Can Trablus, Didem; Demirci, Umut; Karanlık, Hasan; Soyder, Aykut; Dağ, Ahmet; Bilici, Abdullah Yasin; Ertaş Doğan, Mehtap; Köksal, Hilal; Şendur, Mehmet Ali Nahit; Gülçelik, Mehmet Ali; Maralcan, Göktürk; Cabıoğlu, Neslihan; Yeniay, Levent; Utkan, Zafer; Şimşek, Tuncay; Karadurmuş, Nun; Dağlar, Gülseren; Yıldız, Barış Doğu; Uras, Cihan; Tükenmez, Mustafa; Yıldırım, Ahmet Özgür; Kutun, Suat; Özaslan, Cihangir; Karaman, Niyazi; Akçay, Müfide Nuran; Toktaş, Osman; Sezgin, Efe Cumhur[Abstract Not Available]Öğe The satisfaction of patients with breast cancer undergone immediate reconstruction with implant and the effect of radiotherapy(Elsevier Science Ltd, 2018) Yıldırım Altınok, Ayşe; Şenel Beşe, Nuran; Kara, Halil; Yazar, Şükrü; Uras, CihanBackground: Postmastectomy reconstructive surgery for cosmetic satisfaction of patients is rapidly increasing. Postoperative complications such asinfection, capsular contracture, implant loss are more common in patientswho receive adjuvant radiotherapy (RT) than those who do not. Satisfactionlevels in patients is still a controversial issue. Therefore, we wanted toinvestigate our patient population for the effects of RT and planned a studyevaluating the satisfaction rates of our patients who received implants.Material and Methods: Seventy five breast cancer patients who wentthrough mastectomy and went through reconstruction using expanders orsilicone implants were surveyed. Complication and cosmetic satisfactionrates were separately compared between irradiated and nonirradiatedimplants. Responses of 46 patients who answered the survey were analyzedusing chi-square test and Mann Whitney U test. p < 0.05 was consideredstatistically significant.Results: Thirty-one of the patients received adjuvant RT and 15 did notreceive RT (NRT). There was no difference between the RT and NRT groupsin the terms of touch, size, shape of silicones, pain and satisfaction level inlook of clothing. Only satisfaction in symmetry was significantly lower in theRT group than in the NRT group (p = 0.02). Additionally, patients receiving
